Healthcare Provider Details

I. General information

NPI: 1245182138
Provider Name (Legal Business Name): AMANDA MARIE RAGER LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N SELMA RD
WENDELL NC
27591-9639
US

IV. Provider business mailing address

35 YANCEY RD
ZEBULON NC
27597-9302
US

V. Phone/Fax

Practice location:
  • Phone: 919-737-7797
  • Fax:
Mailing address:
  • Phone: 919-215-1845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22985
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14160372-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: